Making Health Care Work

Delivering on the Promise of Quality, Affordable Health Care

Now the fight for health care reform is in Madison, and so are the health care industry’s lobbyists.

At stake is how we set up a new insurance marketplace in Wisconsin — the single biggest tool we have to clean up health care. The new state insurance exchange will allow small businesses, those of us who buy health care on our own, and the uninsured to shop for cheaper health care plans and find some relief from increasingly brutal premiums.

Done right, the exchange will save billions and level the balance of power between consumers and the health care industry — driving the industry to cut waste and prioritize high-quality care.

The health care industry has spent millions to influence health care, so they know how high the stakes are.

In order to help us fight back against the kind of price jumps and trap-door coverage we’ve all been suffering, WISPIRG is pushing to see that the exchange:

1) Negotiates for better plans. By demanding better care for less cost, the exchange can use the collective power of hundreds of thousands of Wisconsinites to finally demand that the industry do better.

2) Have high standards, so that bad plans aren’t an option.

3) Be open to as many Wisconsinites as possible. Limits that shut some individuals and businesses out of the exchange would reduce its ability to lower costs — and will be a key tactic that industry lobbyists use to weaken it.

4) Be accountable to the public.

Issue updates

Many consumers who buy their own health insurance face a big decision right now. Should you renew your existing plan, or switch to a new one? Here are our tips for consumers, and a checklist to help you make the decision that’s right for you:

What if I told you that major pharmaceutical companies had paid off their competition to delay the release of lower-cost generic drugs for 20 major pharmaceuticals? And that combined, brand name drug companies made an estimated $98 billion in total sales of these 20 drugs while the generic versions were delayed? Unfortunately, it’s true, and it means that too many sick Wisconsinites either can’t afford the prescription medication they need, or are paying 10 times too much.

Too often, consumers are forced to shoulder a heavy financial burden, or even go without needed medicine, due to the high cost of brand-name drugs. Our research indicates that one significant cause is the practice called “pay for delay,” which inflates the drug prices paid by tens of millions of Americans.

Wisconsinites with cancer, heart disease, epilepsy and other conditions have been forced to pay an average of 10 times more than necessary for at least 20 blockbuster drugs, according to a report released by the Wisconsin Public Interest Research Group (WISPIRG) and Community Catalyst. The report, “Top Twenty Pay-for-Delay Drugs: How Drug Industry Payoffs Delay Generics, Inflate Prices and Hurt Consumers,” reveals that these drugs were subject to an industry practice called “pay for delay,” in which brand name pharmaceutical companies pay off generic drug manufacturers to keep lower cost equivalents off the market, forcing consumers to pay higher brand-name drug prices.

Everyone knows prescription drugs cost more than they should. But I find many people are surprised to learn about one of the key ways drug companies keep prices high: Paying off competitors to keep generics off the market.

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What if I told you that major pharmaceutical companies had paid off their competition to delay the release of lower-cost generic drugs for 20 major pharmaceuticals? And that combined, brand name drug companies made an estimated $98 billion in total sales of these 20 drugs while the generic versions were delayed? Unfortunately, it’s true, and it means that too many sick Wisconsinites either can’t afford the prescription medication they need, or are paying 10 times too much.

Wisconsinites with cancer, heart disease, epilepsy and other conditions have been forced to pay an average of 10 times more than necessary for at least 20 blockbuster drugs, according to a report released by the Wisconsin Public Interest Research Group (WISPIRG) and Community Catalyst. The report, “Top Twenty Pay-for-Delay Drugs: How Drug Industry Payoffs Delay Generics, Inflate Prices and Hurt Consumers,” reveals that these drugs were subject to an industry practice called “pay for delay,” in which brand name pharmaceutical companies pay off generic drug manufacturers to keep lower cost equivalents off the market, forcing consumers to pay higher brand-name drug prices.

The U.S. Supreme Court will rule Thursday whether all or parts of the Affordable Health Care Act the Obama Administration designed are constitutional. Several facets of the act have already been enacted, according to Bruce Speight, director of WISPIRG - the Wisconsin Public Interest Group or WISPIRG. Listen here: http://www.wuwm.com/news/wuwm_news.php?articleid=10683.

The outcome of the U.S. Supreme Court’s ruling on the Affordable Care Act (ACA) will have far reaching impacts on consumers. The law is already working to improve the quality of care and reduce costs, with millions of Americans experiencing concrete improvements in their coverage. Further improvements are slated to go into effect in 2014 – including a long-awaited ban on insurance companies denying coverage to people with pre-existing conditions, and the opening of competitive state health insurance marketplaces called “exchanges” aimed at giving consumers better choices for coverage.

In 2007, the president signed a WISPIRG-backed law to rein in the makers of drugs like Vioxx, Paxil and Avandia, all of which had dangerous and deadly side effects. The bill reforms the Food and Drug Administration’s drug safety review process, makes drugs safer, and holds drug makers more accountable for the safety of consumers.

Many consumers who buy their own health insurance face a big decision right now. Should you renew your existing plan, or switch to a new one? Here are our tips for consumers, and a checklist to help you make the decision that’s right for you:

Too often, consumers are forced to shoulder a heavy financial burden, or even go without needed medicine, due to the high cost of brand-name drugs. Our research indicates that one significant cause is the practice called “pay for delay,” which inflates the drug prices paid by tens of millions of Americans.

States have an important opportunity to improve their health care marketplaces through the creation of an exchange. And the health reform law gives the states substantial leeway to define critical aspects of the exchange, including who is eligible to buy coverage through it, how aggressively it will set standards and negotiate with insurers, and who will run it. A weak exchange could wind up taking its cues from the insurance industry, not consumers, and do little to shift the fundamental problems in most states’ health care markets.

The opportunity to create a state exchange will allow Wisconsin to increase competition and improve choices in our insurance market. However, to fully realize this opportunity, the exchange must be accountable to the public, and the individual and small business consumers who will buy their coverage through it.

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Everyone knows prescription drugs cost more than they should. But I find many people are surprised to learn about one of the key ways drug companies keep prices high: Paying off competitors to keep generics off the market.

We understand that the Affordable Care Act and its core components, including the health insurance exchanges, have become highly polarized and partisan, despite being solutions that have been embraced by both Republicans and Democrats for many years. But, it is a time for cool heads to prevail and for Governor Walker and state leaders to do what is right for Wisconsin - develop a state-based health insurance exchange.